D21.0: Benign neoplasm of connective and other soft tissue of head, face and neck
D21.0, benign neoplasm of connective and other soft tissue of head, face and neck, is listed as a covered diagnosis in 4 Medicare billing and coding articles that apply to 19 HCPCS Level II codes, including G0453 (Continuous intraoperative neurophysiology monitoring, from…), E0783 (Infusion pump system, implantable, programmable (includes…), E0786 (Implantable programmable infusion pump, replacement…). 4 of these codes have a 2026 DMEPOS fee schedule amount; E0783 pays $9,917.33 to $11,667.45 (NU) depending on the state. The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with D21.0 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| G0453 | Continuous intraoperative neurophysiology monitoring, from outside the operating room (remote or nearby), per patient, (attention directed exclusively to one patient) each 15 minutes (list in addition to primary procedure) | Carrier judgment | — | 2 |
| E0783 | Infusion pump system, implantable, programmable (includes all components, e.g., pump, catheter, connectors, etc.) | Special coverage instructions apply | $9,917.33–$11,667.45 (NU) | 1 |
| E0786 | Implantable programmable infusion pump, replacement (excludes implantable intraspinal catheter) | Special coverage instructions apply | $10,969.75–$11,380.88 (NU) | 1 |
| E0782 | Infusion pump, implantable, non-programmable (includes all components, e.g., pump, catheter, connectors, etc.) | Special coverage instructions apply | $5,200.92–$6,118.73 (NU) | 1 |
| E0785 | Implantable intraspinal (epidural/intrathecal) catheter used with implantable infusion pump, replacement | Special coverage instructions apply | $572.38–$673.39 (KF) | 1 |
| J7999 | Compounded drug, not otherwise classified | Special coverage instructions apply | — | 1 |
| J2278 | Injection, ziconotide, 1 microgram | Special coverage instructions apply | — | 1 |
| J2274 | Injection, morphine sulfate, preservative-free for epidural or intrathecal use, 10 mg | Special coverage instructions apply | — | 1 |
| A4220 | Refill kit for implantable infusion pump | Special coverage instructions apply | — | 1 |
| J9200 | Injection, floxuridine, 500 mg | Special coverage instructions apply | — | 1 |
| G2187 | Patients with clinical indications for imaging of the head: head trauma | Carrier judgment | — | 1 |
| G2188 | Patients with clinical indications for imaging of the head: new or change in headache above 50 years of age | Carrier judgment | — | 1 |
| G2189 | Patients with clinical indications for imaging of the head: abnormal neurologic exam | Carrier judgment | — | 1 |
| G2190 | Patients with clinical indications for imaging of the head: headache radiating to the neck | Carrier judgment | — | 1 |
| G2191 | Patients with clinical indications for imaging of the head: positional headaches | Carrier judgment | — | 1 |
| G2192 | Patients with clinical indications for imaging of the head: temporal headaches in patients over 55 years of age | Carrier judgment | — | 1 |
| G2193 | Patients with clinical indications for imaging of the head: new onset headache in pre-school children or younger (<6 years of age) | Carrier judgment | — | 1 |
| G2194 | Patients with clinical indications for imaging of the head: new onset headache in pediatric patients with disabilities for which headache is a concern as inferred from behavior | Carrier judgment | — | 1 |
| G2195 | Patients with clinical indications for imaging of the head: occipital headache in children | Carrier judgment | — | 1 |
Medicare policy articles listing D21.0
- A57604: Billing and Coding: Intraoperative Neurophysiological Testing (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34623, L35003
- A56722: Billing and Coding: Intraoperative Neurophysiological Testing (Novitas Solutions, Inc. (MAC - Part A, MAC - Part B); 1 Level II codes). LCD with the same title: L34623, L35003
- A56695: Billing and Coding: Implantable Infusion Pump (Palmetto GBA (MAC - Part B); 9 Level II codes). LCD with the same title: L33461
- A56612: Billing and Coding: CT of the Head (Palmetto GBA (MAC - Part A, MAC - Part B); 9 Level II codes). LCD with the same title: L34417
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Frequently asked questions
Does Medicare cover D21.0 (Benign neoplasm of connective and other soft tissue of…)?
Medicare covers items and services, not diagnoses. 4 Medicare billing and coding articles list D21.0 as a covered diagnosis for 19 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 D21.0?
The Level II codes from the policies most specific to this diagnosis are G0453 (Continuous intraoperative neurophysiology monitoring, from…, 2 articles); E0783 (Infusion pump system, implantable, programmable (includes…, 1 article); E0786 (Implantable programmable infusion pump, replacement…, 1 article); E0782 (Infusion pump, implantable, non-programmable (includes all…, 1 article); E0785 (Implantable intraspinal (epidural/intrathecal) catheter…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with D21.0?
Under the 2026 DMEPOS fee schedule (non-rural state fees): E0783 $9,917.33 to $11,667.45 (NU); E0786 $10,969.75 to $11,380.88 (NU); E0782 $5,200.92 to $6,118.73 (NU); E0785 $572.38 to $673.39 (KF). Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list D21.0?
A57604 (Billing and Coding: Intraoperative Neurophysiological Testing); A56722 (Billing and Coding: Intraoperative Neurophysiological Testing); A56695 (Billing and Coding: Implantable Infusion Pump), and 1 more article.
What is ICD-10-CM code D21.0?
D21.0 is the ICD-10-CM code for benign neoplasm of connective and other soft tissue of head, face and neck, in category D21 (Other benign neoplasms of connective and other soft tissue), chapter 2: Neoplasms.
Next steps
- Run a reimbursement report for a device billed under G0453
- Watch G0453 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for G0453
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.